Relaparotomy Following a Resection for Gastric Cancer.
- Author:
Gi Bong CHAE
1
;
Young Jae MOK
;
Tae Jin SONG
;
Jae Bok LEE
;
Seoung Ju KIM
;
Sang Yong CHOI
;
Hong Yong MOON
;
Bum Hwan KOO
;
Sae Min KIM
;
Chong Suk KIM
Author Information
1. Department of Surgery, College of Medicine, Korea University.
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Relaparotomy;
Recurrence;
Non-recurrence
- MeSH:
Cholecystectomy;
Cholecystitis;
Diagnosis;
Enterostomy;
Gastrectomy;
Humans;
Intestinal Obstruction;
Laparotomy;
Neoplasm Metastasis;
Ostomy;
Postoperative Complications;
Recurrence;
Retrospective Studies;
Stomach Neoplasms*
- From:Journal of the Korean Surgical Society
1999;56(2):217-224
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: There has been a general feeling among surgeons that recurrence or metastasis following a curative gastric resection is a hopeless surgical proposition. This study was conducted to evaluate the clinical features and significance of relaparotomy following a gastrectomy for gastric cancer. METHODS: Fifty-six cases of relaparotomies following resection for 53 gastric cancer patients, which were performed over a nine-year period, were investigated retrospectively. On preoperative diagnosis, there were 17 cases of remnant and anastomotic recurrence, 15 cases of intestinal obstruction, 7 cases of cholecystitis, 7 cases of rectosigmoid obstruction, 5 cases of E-loop obstruction and 5 cases of other diseases. RESULTS: Of all the laparotomies eleven cases (19%) were non-recurrence, benign diseases and forty-six (81%) were recurrence. In the 17 cases of remnant and anastomotic recurrence, re-resection was possible in 13 (76%) and major postoperative complications developed in 4 cases with 2 cases of death within one month. Also 6 of 7 re-resected cases which was stage I at first operation were still alive well. In 15 cases of mechanical obstruction, 5 cases were non-recurrence and 10 cases involved recurrence, of which 6 had a bypass or enterostomy and 4 an exploration only. All cholecystitis cases had a cholecystectomy; metastasis was found in 2 cases. Rectal obstruction and E-loop obstruction all involved recurrence and a palliative resection was possible in only one case of each type of obstruction. CONCLUSIONS: In a relaparotomy of remnant and anastomotic recurrence, most of the survival-improving re-resection cases were in stage I at the first operation. In late-onset cholecystitis tumor recurrence should be suspected and a relaparotomy of the malignant obstruction, with bypass and ostomy procedure, can be justified for symptomatic relief.
